Correlation of sPD1 with Procalcitonin and C-Reactive Protein Levels in Patients with Sepsis.

OBJECTIVE: Sepsis results from dysregulated host responses to infection, and it is a major cause of mortality in the world. Co-inhibitory molecules, such as PD-1, play a critical role in this process. Considering the lack of information on the relation between sPD1 and sepsis, the present study aimed to examine the sPD1 level in septic patients and evaluate its correlation with procalcitonin (PCT) and C-reactive protein (CRP) levels. MATERIALS AND METHODS: This descriptive cross-sectional study consisted of three groups, including septic patients (n=15), suspected of sepsis (n=15), and healthy subjects (n=15). White blood cells (WBCs) and platelet (PLT) counts are evaluated. The serum levels of CRP, PCT, and sPD1 were measured by immunoturbidimetric assay, electrochemiluminescence technology, and the enzyme-linked immunosorbent assay (ELISA), respectively. RESULTS: Our study indicated that there was a significant difference in WBC and PLT counts between the septic group compared to suspected and control groups (P<0.001, P<0.01, respectively). The CRP level was significantly higher in septic compared to suspected and control groups (P<0.001). There was also a significant difference between the PCT level in septic and suspected groups in comparison with the controls (P<0.001, P<0.01). The sPD1 level was significantly higher in septic patients compared to suspected and control groups (P< 0.001). In septic patients, sPD1 levels were correlated positively with the CRP and PCT levels. CONCLUSION: Overall, sPD1 correlation with inflammatory markers, might propose it as a potential biomarker to sepsis diagnosis. However, the clinical application of serum sPD-1 testing in patients with sepsis requires further investigation.

Procalcitonin: a reliable marker for the diagnosis of neonatal sepsis.

OBJECTIVES: In the last few years, serum procalcitonin has been proposed as an early marker of infections in neonates, with varying results. In this study, we aimed to investigate the value of procalcitonin, and C- reactive protein in establishing the diagnosis of neonatal sepsis. MATERIALS AND METHODS: Blood samples were collected at admission from 69 neonates with suspected infection (admitted to the Neonatal Intensive Care Units at Alzahra and Dr Beheshti Hospital in and Fatema-Zahra in Najafabad from May 2005 to April 2006). Patients were categorized in different groups according to clinical symptoms of sepsis, bacteriological and laboratory results. Group I consisted of 20 newborns with positive blood cultures and other biological tests which suggested infection. Group II consisted of 49 neonates with negative blood cultures but had two or three of clinical signs of sepsis. The control group included 18 healthy neonates with physiological hyperbilirubinemia and no clinical and biological data of infection, referred to the hospital for bilirubin determination. Procalcitonin and C-reactive protein (CRP) were determined by immunoluminometric assay and nephlometry method respectively. RESULTS: Mean levels of procalcitonin and CRP in septic neonates (group I) were significantly higher than the other two groups (P< 0.005). Sensitivity, specificity, positive predictive value and negative predictive value were determined for all markers and compared with each other. CONCLUSION: We conclude that procalcitonin is a better marker than CRP in the diagnosis of neonatal sepsis.

Distribution of HLA-B*27 alleles in patients with ankylosing spondylitis in Iran.

BACKGROUND: HLA-B*27 is strongly associated with ankylosing spondylitis (AS). It represents a family of alleles that differ among ethnic groups. OBJECTIVE: The aim of this study was to determine the distribution of HLA-B*27 alleles in AS patients and healthy controls in Isfahan (Iran). METHODS: Sixty AS patients and 430 healthy blood donors were selected. All subjects were HLA-B*27 positive by flow cytometry. HLA-B*27 subtypes were determined by PCR-SSP. RESULTS: Forty patients (66.7%) and 17 controls (3.95%) were HLA-B*27 positive. Subtypes detected by PCR-SSP were B*2705, B*2702, B*2704 and B*2707. One patient was B*2702/B*2710. No significant difference was found in the distribution of these alleles between AS patients and controls. CONCLUSION: Although Caucasian subtypes are predominant among Iranians, this population is characterized by a combination of both specific Caucasian and Oriental subtypes. However such results should be interpreted carefully because of the small sample size in our investigation and definitive conclusion awaits more ethnic-group studies.

Evaluation of CD11b expression on peripheral blood neutrophils for early detection of neonatal sepsis.

Neonatal sepsis is a disease of infants who are less than 1 month of age. These infants are clinically ill, and their blood culture are positive for bacteria. The reported incidence of neonatal sepsis for all infants is 1 to 10 per 1000 live births. The mortality rate is 4.2-26%. The clinical signs are not specific and diagnosis of neonatal sepsis is one of the most difficult tasks in clinical medicine. The aim of this work was determination of CD11b sensitivity and specificity for early detection of neonatal sepsis. We studied 65 neonates with gestational age of 27 to 38 weeks who were suspected for sepsis within the 28 days of life. Whole blood was obtained from neonates to determine CD11b expression on peripheral blood neutrophils by flow cytometry. C-Reactive protein (CRP) was measured qualitatively. Neonates were divided into two groups. Classification was based on the result of the blood culture. In the sepsis group all of the neonates (n=8) showed positive blood culture and clinical symptoms. In the suspected group (n=57) the neonates showed clinical signs but blood cultures were negative. Sensitivity and specificity of CD11b were 75%, 100% respectively. Also positive and negative predictive values of CD11b were 100% and 86% respectively. Results of present study and previous studies showed that measurement of neutrophil surface markers can be useful for diagnosis of infection in the early phases. Also, the quantitative measurement of CRP in addition to CD11b further enhances the ability to diagnose infections and improves sensitivity and negative predictive value by 100%.